There’s been enough talk about treat­ment for the men­tally ill. It’s time for Fair­fax County to act.

The Washington Post Sunday - - METRO - The writer is a mem­ber of Fair­fax County’s Ad Hoc Po­lice Prac­tices Re­view Com­mis­sion and au­thor of “Crazy: A Fa­ther’s Search Through Amer­ica’s Men­tal Health Mad­ness.”

If Natasha McKenna had lived in Bexar County, Tex., in­stead of Fair­fax County, the 37-year-old would have re­ceived treat­ment for her schizophre­nia rather than dy­ing af­ter be­ing stunned by a deputy sher­iff four times with 50,000-volt shocks from a Taser while her arms and legs were shack­led and her face cov­ered with a hood.

More than a dozen years ago, Fair­fax and Bexar County of­fi­cials de­cided to in­ves­ti­gate jail-di­ver­sion pro­grams that would di­rect peo­ple such as McKenna into com­mu­nity treat­ment for men­tal dis­or­ders in­stead of into jail.

Bexar County, which con­tains San An­to­nio, cre­ated a sys­tem that is her­alded as a na­tional model. In 2002, its first year, nearly 1,000 peo­ple with men­tal ill­nesses were di­verted from jail and emer­gency rooms into com­mu­nity treat­ment fa­cil­i­ties. To­day, the pro­gram di­verts more than 4,000 in­di­vid­u­als each year and is sav­ing at least $5 mil­lion an­nu­ally in jail costs and $4 mil­lion an­nu­ally on in­ap­pro­pri­ate ad­mis­sions to emer­gency rooms. What has Fair­fax County done? Its lead­ers have held meet­ings, com­piled re­ports and talked, talked, talked.

Mean­while, each day roughly one­fourth of the more than 1,200 in­mates at the Fair­fax Detention Cen­ter, who have se­ri­ous men­tal ill­nesses such as schizophre­nia, re­main in­car­cer­ated at a cost to Vir­ginia tax­pay­ers of more than $50,000 per in­mate per year. Fifty per­cent of jail in­mates have men­tal health and/or sub­stance abuse dis­or­ders. Many are charged with tres­pass­ing and other mi­nor crimes re­lated to their ill­nesses.

A key com­po­nent of the Bexar model was the cre­ation of a 24-hour Cri­sis Care Cen­ter — a 10-bed fa­cil­ity in San An­to­nio staffed by ther­a­pists that serves as a drop-off al­ter­na­tive to the jail and emer­gency rooms. Most of the 14 pa­tients ad­mit­ted there each day can be sta­bi­lized within 24 hours. Those who can’t are moved to pri­vate hos­pi­tals or state fa­cil­i­ties.

The Vir­ginia leg­is­la­ture set aside $1.8 mil­lion to add six cri­sis drop-off cen­ters to the 18 in the state. There has been talk of build­ing a Fair­fax drop-off cen­ter on the site of the county-owned Massey Build­ing. But Fair­fax of­fi­cials an­nounced that they would ap­ply for a state grant to fund such a cen­ter only af­ter McKenna’s pre­ventable death.

The Bexar County ju­di­ciary uses a men­tal-health court to cull peo­ple with men­tal dis­or­ders from its crim­i­nal caseload and di­rect them into treat­ment. Vir­ginia has men­tal-health dock­ets in four ju­ris­dic­tions, most re­cently in Prince Wil­liam County. Not Fair­fax, even though a study by Old Do­min­ion Uni­ver­sity found that the Nor­folk men­tal-health docket trans­lated into fewer re­peat of­fend­ers, less jail time, im­proved men­tal health through treat­ment and a jail-costs sav­ings of $1.63 mil­lion over 18 months. In Peters­burg’s court, only four of 50 peo­ple (8 per­cent) in the pro­gram re-of­fended, in sharp con­trast with the 60 per­cent to 75 per­cent re­cidi­vism rate in Peters­burg.

Fair­fax Gen­eral Dis­trict Court Chief Judge Pen­ney Az­carate launched a vet­er­ans docket this year, but her Cir­cuit Court col­leagues have stub­bornly re­fused to im­ple­ment a men­tal-health docket.

In­cred­i­bly, af­ter McKenna’s death, the Fair­fax-Falls Church Com­mu­nity Ser­vices Board, which over­sees men­tal­health ser­vices, moved to elim­i­nate a staff po­si­tion in the jail to save money. The board re­lented af­ter ad­vo­cates protested, but it con­cocted an­other cost­cut­ting scheme that will re­move an on-site su­per­vi­sor from the jail, weak­en­ing its al­ready in­suf­fi­cient ser­vices.

A men­tal-health ad­vo­cate and Bexar County judge were re­spon­si­ble for bring­ing law en­force­ment, the ju­di­ciary, men­tal-health providers and com­mu­nity lead­ers to­gether to cre­ate that county’s di­ver­sion pro­gram. That co­op­er­a­tion in­cluded cost-shar­ing. Although the Fair­fax Sher­iff ’s Of­fice is legally re­spon­si­ble for med­i­cal ser­vices in the jail, it pays noth­ing for in­mate men­tal-health care. Nei­ther does the Fair­fax County Po­lice Depart­ment. The Com­mu­nity Ser­vices Board shoul­ders those costs alone — us­ing funds badly needed for com­mu­nity men­tal-health treat­ment pro­grams.

Sharon Bulova, chair­man of the Fair­fax County Board of Su­per­vi­sors, should fol­low Bexar County’s ex­am­ple and use her bully pul­pit to re­quire Fair­fax Po­lice Chief Ed­win C. Roessler Jr., Sher­iff Stacey Kin­caid and the Com­mu­nity Ser­vices Board to pool fi­nances to fund a Bexar County model. The Fair­fax ju­di­ciary should be pres­sured by tax­pay­ers to get on board.

Bexar County, Or­lando, Seat­tle, Miami and Ohio’s Franklin County, which con­tains Colum­bus, have im­ple­mented suc­cess­ful jail di­ver­sion pro­grams that save lives and tax dol­lars. Fair fax County missed its op­por­tu­nity once. It would be un­con­scionable to re­peat that mis­take.


A re­straint chair in the Fair­fax County jail.


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